According to the Vision Council of America, nearly 75% of adults use some sort of corrective visual lenses. Whether you prefer stylish glasses or invisible contacts, your eyes are a vital resource. They should be maintained in order to live life to its fullest. If you’re planning to use your Medicare benefits to offset the cost of corrective lenses, you should know that Original Medicare benefits won’t often meet all of your needs. Often, Original Medicare won’t cover vision-related expenses at all. That can out you hundreds of dollars out-of-pocket each year if you aren’t careful.
No Routine Vision Care
If you’re enrolled in Medicare Part A, you will not receive any coverage for routine vision exams or eye refractions (which is a fancy word for the test used to determine your prescription). You will need to pay your doctor fees as well as the costs of glasses or contacts out of pocket. Medicare Part B will not cover refractions, eyeglasses, or contact lenses. However there may be coverage if you need vision correction after cataract surgery.
If you have Medicare Advantage (Part C), you may receive a few routine vision benefits. Medicare Part D will also give you a few benefits, such as prescription eye drops and various prescription eye medications.
What Medicare Does Cover
Medicare Parts A and B generally do not offer any vision-related coverage benefits, and Part D provides for basic medications. What, then, is Medicare good for when it comes to your vision? If you have a chronic eye condition such as glaucoma or cataracts, Medicare will cover the cost of procedures needed to repair your eye’s functionality (such as cataract surgery). Medicare may also cover diagnostic tests and treatment programs related to macular degeneration. As mentioned above, Medicare may also pay for prescription eye glasses if they are medically necessary after certain types of surgery. Medicare also pays for glaucoma screenings. In some cases it may pay for eye exams if you demonstrate vision problems that indicate a serious eye condition.
Finally, there are a few specific circumstances where Medicare may pay for routine eye care. If you have diabetes, Medicare will pay for an annual eye exam to check for diabetes-related eye diseases. If you are at risk for glaucoma, Medicare will pay for an annual preventative eye exam. Medicare considers you at risk for glaucoma if you have diabetes, a family history of glaucoma, are an African-American age 50 or older, or are Hispanic and age 65 or older.
Relying on Medicare to foot your vision-related bills may not be the best course of action. Although most individuals may need corrective lenses for everyday living, Medicare usually doesn’t cover them unless you meet a specific set of criteria. We recommend that you augment your Original Medicare coverage with supplemental vision insurance plans or savings in order to keep your eyes in tip top shape.